Care Connector

Amerihealth Caritas•,

12d•Hybrid

About The Position

The Care Connector is responsible for supporting the daily operations of integrated care management and utilization management program interventions. The Care Connector performs in a contact center environment, effectively processing calls from Members, Providers and other areas, internal and external to the company. The CC identifies members with Care Gaps/HEDIS related health conditions and assists them in accessing care through Plan benefits and community resources. Under the direction of Clinical staff, the Care Connector will provide members with educational materials and carry out strategies to increase health care adherence and reduce barriers to care.

Requirements

High School Diploma or equivalent required
Minimum of 2 years previous work experience, preferably in a health care setting
Proficient PC skills in a Windows-based environment, MS Office products, including word processing, spreadsheets, and database programs
Excellent interpersonal and verbal communication skills and the ability to write clear and concise reports
Attention to detail and confidentiality with strong organizational skills
Access to a reliable high-speed internet connection (minimum 50 Mbps download and 5 Mbps upload) to support daily job responsibilities for remote or hybrid roles.

Nice To Haves

Managed care experience preferred.
Medical terminology, ICD, CPT, and/or coding experience preferred
Strongly prefer Medical Assistant, Home Health Aide, Nursing Assistant, or other similar health care para-professional training or certification
Prior member service or customer service telephone experience desired
Prior behavioral health experience is a plus
Experience with maternity patients and members is a plus

Responsibilities

Supporting the daily operations of integrated care management and utilization management program interventions.
Performing in a contact center environment, effectively processing calls from Members, Providers and other areas, internal and external to the company.
Identifying members with Care Gaps/HEDIS related health conditions and assisting them in accessing care through Plan benefits and community resources.
Providing members with educational materials and carrying out strategies to increase health care adherence and reduce barriers to care, under the direction of Clinical staff.